Esmeralda McNeil
San Antonio,TX
Summary
A triage RN with exceptional communication skills, I specialize in ensuring continuity of care and quick clinical decision-making. Proficient in Epic, Cerner, Meditech, and Kantime EHR, as well as STCC, Clear Triage, and TriageLogic triage protocol software, I efficiently utilize these systems to document assessments, escalate concerns, and coordinate care across interdisciplinary teams. Skilled at navigating complex workflows while maintaining composure under pressure, I provide effective support to patients and providers in fast-paced environments.
Overview
22
22
years of professional experience
Work History
Pediatric Home Health RN
Pediatric Private Duty Nursing
12.2024 - Current
- Provided compassionate nursing care to medically fragile children in home settings.
- Identified health issues while at home care visits and contacted patient's physician to discuss best method for resolution.
- Communicated with patients and family members, providing detailed information regarding care and medications.
- Tracked patients' progress through careful reporting and documentation at each visit.
- Provided direct patient care, stabilized patients, and determined next course of action.
RN - MSPCU-7
HCA - Methodist Hospital
11.2023 - 12.2024
- Apply the nursing process, critical thinking skills, scientific judgment, technical skills and leadership to independently deliver safe nursing care to patients
- Assess patient condition during admission and during each shift, identifying and reporting any changes in patient status
- Perform procedures or other functions as ordered by the medical provider
- Document the administration of care in the patient medical record in a timely and thorough manner
- Perform the administration of prescribed medications and monitors response
- Maintain a knowledge of medications, procedures, and equipment used in the care of post ICU and medical-surgical patients
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Triage RN - Emergency Department
HCA - Methodist Hospital
11.2023 - 08.2024
- Apply the nursing process, critical thinking skills, scientific judgment, technical skills and leadership to independently deliver safe nursing care to patients.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Monitored patient reactions to drugs and carefully documented findings.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Scheduled appointments for patients not requiring emergency services but needing examination from provider and consulting directly with provider.
- Suggested appropriate disposition to acting physicians based on assessment.
- Verified patient insurance eligibility and identified primary care physician, contacting office to obtain patient file.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Travel LVN- LTC
Fusion Medical Staffing
02.2023 - 11.2023
- Give directions to Nurse Aides for appropriate care of residents
- Properly administer resident medication
- Implement resident care plans in compliance with Company and federal guidelines and physician's orders
- Accurately and promptly transcribe physician orders
- Timely and accurate documentation of residents' charts
- Complete Nursing assessment as required
- Participate in shift reports
- Maintain a safe working environment, complying with infection control and body mechanic procedures
Travel LVN - LTC
Fusion Medical Staffing
10.2022 - 01.2023
- Assessing, planning, and implementing resident care in the memory care unit
- Assessed need for, ordered, obtained, and interpreted appropriate lab tests
- Chronic patient care in memory care unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 15-30 patients per shift
- Charge nurse on a LTC unit
- Oversaw average of 15-30 patients per shift
Triage LVN - Refugee Resettlement Operations
Garda world Federal
04.2021 - 10.2022
- Work with UC and asks questions about their health for diagnosis and documenting UC's symptoms and medical history in Spanish to translate in English for the provider
- Assesses a UC needs and provides care
- Identifying changes in UCs' symptoms and intervening in emergency situations
- Participates in pain management for UC's
- Administers medications and gives vaccinations following age-appropriate guidelines
- Monitors temperature, pulse, breathing, and blood pressure and keeping accurate records
- Documented accurate and complete patient information to address patient problems and expected outcomes.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Scheduled appointments for patients not requiring emergency services but needing examination from provider and consulting directly with provider.
- Performed routine evaluations of each patient's status, needs, and preferences.
LVN - Covid-19 Vaccinator - LTC facilities in Texas
Angel Healthcare Staffing
09.2020 - 04.2021
- Provided bedside care, medication administration, vital signs (i.e., temperature, pulse, respiration, and blood pressure), accu-checks, urinary catheter care, tracheostomy care, colostomy care, daily I/O recording
- Reported abnormalities to the charge RN
- Administered medication timely and accurately
LVN - Covid-19 EMD Louisiana and Texas
BCFS HHS
02.2020 - 09.2020
- Provided bedside care by obtaining vital signs of patients (i.e., temperature, pulse, respiration, and blood pressure)
- Reported abnormalities to the charge RN
- Administered medication timely and accurately
- Obtained patient vital signs and input/output measurements from inpatients.
- Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
- Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
- Documented accurate and complete patient information to address patient problems and expected outcomes.
LVN - Charge Nurse
Oak Park Nursing & Rehabilitation
01.2019 - 02.2020
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Performed additional clinic and non-triage nurse duties such as instructing patients in general and specific medical care and health issues and administering or dispensing medication and injections.
- Prepare and administer injections and/or enemas
- Coordinated patient treatment protocols with Schmitt-Thompson, and Barton-Schmitt Protocols, and organization specific guidelines to create comprehensive patient care plan.
- Collect samples and monitor catheters
- Monitored compliance and evaluated effectiveness of home treatment instructions.
- Provide wound care
- Reviewed updated Texas and federal patient treatment policies and procedures to optimize patient care while complying with preset guidelines.
- Help coach staff as necessary
LVN
Pediatric Private Duty Nursing, Inc
03.2018 - 01.2020
- Provide care to children with diagnoses including Cerebral Palsy | Prematurity | Autism | Developmental Delay | Down Syndrome | Fragile X | Fetal Alcohol Syndrome
- Deliver in-home nursing services that include Wound Dressing & Care, Ventilator & Tracheostomy Suctioning/Care, G-Tube Feedings & Care, Respiratory Treatments & Assessments, IV Therapy, Patient Bathing & Hygiene Assistance, Glucose Checks & Blood Pressure Monitoring
- Follow rehabilitation and treatment plans to accelerate patient recovery; minimize pain, discomfort, infections, and complications; and optimize patient outcomes
- Assess, monitor, and document patient progress, symptoms, and vital signs on each visit
- Educate clients and their families on the safe treatment of injuries, illnesses, and conditions
HCC Coder
Optum-UHG
08.2015 - 09.2019
- Review medical records and decipher if they are accurate and complete and in support of patient risk adjustment score
- Review medication list to verify if there is a correlating condition or if an active condition is being treated with medication
- Audit documentation including confirming each condition or screening that is marked as assessed
- Identify appropriate assignment of ICD-10 Codes for Outpatient Physician and facility services provided in an Office setting
- Abstract additional data elements during the Chart Review process when coding, as needed
- Perform provider/practitioner medical record reviews, abstraction and data entry for HEDIS, HQPAF, and Clinical Chart Reviews as part of the Quality and Performance Improvement program
- Responsible for meeting daily production goal and maintaining quality requirement of 98% accuracy
Senior HIM Consultant (Coding Auditor)
United Audit Systems, Inc.
10.2013 - 04.2016
- Audit records/accounts to ensure accuracy of the code assignments using ICD-9-CM and CPT-4, modifiers, for outpatient (facility or physician office professional fee)
- Identify areas where further education is needed related to potential risk areas for coding quality and communicate this with the education department for formulation of action plans or in-services
- Report on the accuracy of the coded and abstracted data elements
- Report noncompliance issues detected through auditing and monitoring
- Utilize internal and qualified external resources to clarify coding policies, guidelines and 'gray areas' while adhering to individual client and contracted facility coding policies
- Communicate information to coding supervisor and project manager
Coder (HCC)
ArroHealth (MedSave USA)
12.2014 - 12.2015
- Review, analyze, and code diagnostic information within a patient's medical record based on client specific guidelines
- Code unique ICD-9 code that maps to HCC/RxHCC according to client specification
- Ensure compliance with established ICD-9, CM coding guidelines, third party reimbursement policies, regulations and accreditation guidelines
Remote Coder
Aviacode
09.2009 - 01.2014
- Responsible for accurately coding inpatient physician evaluation and management services (E&M), bedside minor procedures and renal dialysis services for Temple University Hospital
- In addition to coding, also responsible for entering charges utilizing IDX system
Coding Auditor
Scio Health Analytics (National Audit)
08.2011 - 05.2013
- As a travel consultant, I performed in-house audits at various facilities: hospitals, clinics, urgent care and private offices for multi-specialty providers
- Remotely, my responsibilities included Identify work files to be audited through a query process, evaluate current procedures for efficiency and accuracy
- Perform an extensive review accounts to determine if correct payments were made
- Accurately re-price complex claims using multiple client claims systems
- Document audit findings on spreadsheet
Billing Coder
Geisinger Community Medical Center
05.2011 - 11.2012
- Reviewed patient medical records to assign appropriate levels for E/M services, minor procedures, modifiers and diagnosis for multi-specialties utilizing EMR
- Utilized knowledge and exercised professional judgment regarding medical terminology, disease processes and pharmacology in the assignment of numeric codes under the applicable coding systems
- Using the International Classification of Disease (9th Revision) Clinical modification (ICD-9-CM), Current Procedural Terminology (CPT), the Health Care Financing Administration Common Procedure Coding System (HCPCS) and standards recognized under the National Correct Coding Initiative to assign correct codes
Coding Supervisor/Coding Educator
Pocono Medical Center
04.2003 - 11.2011
- Serve as the liaison for department staff, payers and physicians
- Conduct weekly accounts receivable staff meeting for the purpose of updating staff on current billing issues and discuss billing trends
- Responsible for keeping current with medical compliance and reimbursement policies
- Perform coding and audits for General Surgery, Plastic Surgery, Hospital's Inpatient/Outpatient Services, Ob & Gyn, and Orthopedic provider groups
- Attend seminars and continuing education activities pertinent to coding and billing
Education
RN -
Excelsior University
01.2023
LVN - undefined
Galen School of Nursing
San Antonio, TX01.2017
AS - undefined
Northwest Vista College
San Antonio, TX01.2015
HS - undefined
John Dewey HS
Brooklyn, NY01.1990
Skills
- Community health
- Discharge planning
- Geriatric care
- Compassion and empathy
- Basic life support
- Patient assessments
- KanTime software
- Advanced cardiac life support (ACLS) certification
- English, Spanish fluency
- Emergency response
Affiliations
- American Nurses Association (ANA)
- Texas Nurses Association (TNA)
Languages
Spanish
Native or Bilingual
Timeline
Pediatric Home Health RN
Pediatric Private Duty Nursing
12.2024 - Current
RN - MSPCU-7
HCA - Methodist Hospital
11.2023 - 12.2024
Triage RN - Emergency Department
HCA - Methodist Hospital
11.2023 - 08.2024
Travel LVN- LTC
Fusion Medical Staffing
02.2023 - 11.2023
Travel LVN - LTC
Fusion Medical Staffing
10.2022 - 01.2023
Triage LVN - Refugee Resettlement Operations
Garda world Federal
04.2021 - 10.2022
LVN - Covid-19 Vaccinator - LTC facilities in Texas
Angel Healthcare Staffing
09.2020 - 04.2021
LVN - Covid-19 EMD Louisiana and Texas
BCFS HHS
02.2020 - 09.2020
LVN - Charge Nurse
Oak Park Nursing & Rehabilitation
01.2019 - 02.2020
LVN
Pediatric Private Duty Nursing, Inc
03.2018 - 01.2020
HCC Coder
Optum-UHG
08.2015 - 09.2019
Coder (HCC)
ArroHealth (MedSave USA)
12.2014 - 12.2015
Senior HIM Consultant (Coding Auditor)
United Audit Systems, Inc.
10.2013 - 04.2016
Coding Auditor
Scio Health Analytics (National Audit)
08.2011 - 05.2013
Billing Coder
Geisinger Community Medical Center
05.2011 - 11.2012
Remote Coder
Aviacode
09.2009 - 01.2014
Coding Supervisor/Coding Educator
Pocono Medical Center
04.2003 - 11.2011
LVN - undefined
Galen School of Nursing
AS - undefined
Northwest Vista College
HS - undefined
John Dewey HS
RN -
Excelsior University
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